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Artemisinin-based combination therapies and their introduction in Japan

机译:蒿属植物的组合疗法及其在日本的介绍

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Artemisinin was discovered in 1971 from a herb, Artemisia annua, which had been used for more than 2,000 years in China against intermittent fever. Now, the artemisinin and its derivatives have become essential components of artemisinin-based combination therapies (ACTs). The ACTs are the recommended first-line treatments of malaria because they are effective against all four human malarias, produce rapid parasite/fever clearance, and show fewer adverse effects. Some ACTs are particularly important in cases of severe and complicated falci-parum malaria, including cerebral malaria. However, neither the artemisinin and its derivatives nor any ACTs are registered in Japan. Indeed, the only licensed drugs for the treatment of malaria in Japan are quinine, mefloquine, and sulfadoxine/pyrimethamine. Although indigenous malaria has been eradicated in Japan since 1959, 60-100 imported malaria cases have been reported annually for the past decade. Some of the patients were, in fact, dying of the severe complications. Thus, the introduction of the ACTs and their application to imported malaria patients in Japan are urgently needed. A few clinical studies using the ACTs have been reported in Japan. The first application of an ACT, intramuscular artemether plus mefloquine, was reported in 1988 to be very effective against cerebral malaria with coma. Five cases with intravenous artesunate plus mefloquine were reported through 2001-2007, for severe or drug-resistant falciparum cases, resulting in successful treatment with some side effects such as hemolytic anemia or postmalaria neurological syndrome. Currently, a fixed-dose ACT, artemether-lumefantrine, is prescribed successfully for uncomplicated falciparum cases, with a limited number of recrudescences.
机译:阿尔胺蛋白于1971年发现,来自艾蒿的草本植物,在中国使用了2000多年的时间免于间歇性发烧。现在,青蒿素及其衍生物已成为蒿属植物的组合疗法的基本组分(行为)。该行为是疟疾推荐的一线治疗,因为它们对所有四种人类疟疾有效,产生快速寄生虫/发热清除,并显示出少的不良反应。在严重和复杂的Falci-parum疟疾病例中,一些行为尤为重要,包括脑疟疾。然而,艾蒿和其衍生物和任何行为都没有在日本登记。实际上,日本唯一用于治疗疟疾的持牌药物是奎宁,Mefloquine和磺胺肟/吡米甲胺。尽管自1959年以来,疟疾在日本被消灭,但在过去十年中每年报告60-100例进口疟疾病例。事实上,一些患者死于严重的并发症。因此,迫切需要引入行为及其在日本进口疟疾患者的应用。在日本报道了使用该行为的一些临床研究。 1988年报道了第一次应用ACT,肌肉内蒿甲醚加mefloquine,对昏迷的脑疟疾非常有效。通过2001 - 2007年通过2001-2007报告静脉内艺术株患者静脉内昆虫喹,用于严重或耐药性的恶性病例,导致溶血性贫血或后疗法的一些副作用成功治疗。目前,一种固定剂量的Artemetret-Lumefantrine成功地规定了未经证实的恶性气体病例,有限数量的核糖。

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